Do I keep my parent's secret -- or be the rat?

Dad has sworn me to secrecy about Mom's vascular dementia -- that was the only way I could persuade them to get her diagnosed to begin with. But it's only a matter of time before my siblings start asking questions. I'm closer to my parents (geographically and emotionally) than they are, and so far, I've kept to the bargain. But it's a losing battle. Mom's erratic emotions and declining cognitive abilities are showing.

Every year we all meet at our family lake house. Her condition is going to be obvious. I think my siblings deserve to know, but Dad gets furious every time I bring it up. It's like he's ashamed of it. What do I do?

Face the fact that you might have to be the rat.

But first, see if you can get your dad to let you be the messenger and do the talking for your parents. If he agrees, tell your siblings but ask them to not mention it to your parents for at least a few weeks. That way every person involved can have time to process the roller coaster of emotions that each must face. News like this impacts every one differently -- we all have our own fears and misconceptions about disease and aging and quality of life to work through.

Another way to handle this is to tell your siblings without telling them. By that I mean that you prod them to think about what health problems elders face and what your family would do if, hypothetically, you all had to face this. Let them stumble onto it on their own -- but with a bit of nudging. This will couch the blow.

I strongly suggest that you share this news in a way that doesn't overwhelm your parents or play out their worst fears. Your dad is afraid of how others will take the news, or perhaps he's concerned that your mother will be treated differently. Or maybe it's just too hard to come out and say. Show him and your siblings articles about families who've been through the same thing. Sometimes we can use celebrities' stories (think of Ronald Reagan, and Maria Shriver's parents) to remind ourselves that it's no crime to get a disease, and that families from all walks of life deal with the same challenges.

No matter what your approach, don't let it drag out. Your parents need their adult children to rally around, so they know they don't need to face this alone. I'm reminded of a powerful quote, "We're only as sick as our secrets." Keep reiterating that you are all going to love Mom "because she's Mom," forever -- no disease can take away all she's been and all she still is to you. Your parents -- all of you, really -- are going to need to hear this a lot, especially as you begin to grieve the losses that are happening right in front of you. You're going to get angry at this disease, at all the things you can't fix. You're going to get frustrated with one another. It's all part of the caregiving territory.

This isn't something you can ignore until it goes away. You may not have too much time before you've got some real safety risks that will need addressing. If the lake house reunion approaches and no one has spilled the beans, then spill the beans. Tell your siblings a couple of weeks before and get through that initial fallout period, and then just say to your parents, "We know Mom has vascular dementia, and it's time we pull together and care for one another. That's what the two of you have always taught us to do and that's what we're going to do." Then hug and cry and do whatever your family does to heal and deal.

Will it cause a mess? It might, but the bigger mess will be continuing to try to hide it. In fact, bringing it into the open might be just what your dad wants you to do; maybe he just doesn't know it or doesn't know how to say it. There's so much more to face than to get stuck on this one issue.

I know I keep saying it, but I'll say it one more time: Don't let this stay a secret for too long! Be the rat if you have to. Promises made under duress or with limited knowledge don't have to be honored till your last breath. Life and circumstances change.

I adopted a mantra when I was caring for my mom, who had Parkinson's and Alzheimer's, that I was going to give myself permission to bungle my way through it. I had no idea what each day would bring. Often I had no clue as to how to make any of it the tiniest bit better. I just knew that I'd just have accept my mistakes (and others') along the way. There's no one right way to handle this; just face each hurdle with as much love and courage and humor as you can muster.

And have a great lake house family time, full of laughter and tears -- the stuff memories are made of.

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